NHPCO Calls for Hospice Community to Make its Voice Heard

More Cuts to Hospice Announced: Hospice Community Responds
with Virtual Lobby Day on July 15

(Alexandria, Va) – The nation’s hospice providers are facing proposed cuts of $2.3 billion over a five-year period and $9.8 billion over a ten-year period in the preliminary estimates of the House of Representatives health reform proposal, released last week by the Congressional Budget Office.

These cuts are in addition to the cuts scheduled to go into effect on October 1 as a result of the elimination of the Budget Neutrality Adjustment Factor (BNAF), an issue the hospice community has been fighting to overturn for some time.

This new development makes the need to stop the BNAF cuts even more urgent for hospice providers. On Wednesday, July 15, NHPCO and The Alliance for Care at the End of Life are sponsoring a nationwide Virtual Lobby Day. All Hospice Advocates are called to join together to protect patient access to compassionate and high-quality end-of-life care.

If the BNAF cuts move forward on October 1, just 80 days from now, the hospice community is potentially facing a 6.4 percent reimbursement cut in federal fiscal year 2010 (October 1, 2009 - September 30, 2010).

“The situation facing the hospice community is clear: we are now facing cuts on top of cuts. When you take these proposed cuts, and place them on top of the BNAF scheduled cuts, it is simply unacceptable,” said J. Donald Schumacher, NHPCO president and CEO.

Here's how Virtual Lobby Day will work:

• On Wednesday, July 15, all Hospice Advocates registered on NHPCO’s Legislative Action Center will receive the Virtual Lobby Day information via email.

• The email with include instructions about who to contact, how to contact them, and specific talking points.

• Participants will call and write throughout the day on July 15.

People who have not previously registered on NHPCO’s Legislative Action Center can sign up now—it’s free and open to any interested individual. Go to nhpco.org/advocacy and click the “Legislative Action Center” box.

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Contact:
Angie Truesdale
Ph: 703-647-5163
atruesdale@nhpco.org
or
Jon Radulovic
Ph: 703-837-3139
jradulovic@nhpco.org

For more information visit, http://www.nhpco.org

Letter to President Obama

Hospice Community Urges President Obama to Stop Funding Cuts

Cuts Beginning October 1 Will Reduce Access to Care for Dying Americans

(Alexandria, VA) – Today, 3,524 hospice providers from across the country sent a letter to President Barack Obama urging him to stop cuts to the Medicare hospice benefit beginning on October 1, 2009.

The cuts threaten to jeopardize availability of the compassionate and high-quality care that 1.5 million patients and their family caregivers receive from hospice providers each year.

In addition to the letter, more than 500 providers of the hospice community submitted comments to the Centers for Medicare and Medicaid Services (CMS) on how the cuts will cause them to decrease services, reduce staffing, and in some cases, close their programs.

This follows two Congressional letters sent to President Obama by 45 U.S. Senators and 171 U.S. Representatives, demonstrating that he has strong, bipartisan support to stop the cuts in hospice funding.

The cuts come from a 2008 federal rule that eliminates a component of the Medicare hospice benefit known as the budget neutrality adjustment factor (BNAF). Members of the hospice community have been calling and emailing the Administration requesting that implementation of this rule be stopped.

“The sheer number of hospice programs represented by this letter and those recently sent by Members of Congress should send a strong message to the White House about the urgency in stopping these cuts,” said J. Donald Schumacher, president and CEO of NHPCO.

Earlier this year, President Obama and Congress approved a moratorium on the hospice funding cuts that expires on September 30, 2009. Without further action, hospice reimbursements will drop by 3.1 percent, leaving hospice programs, particularly smaller and rural ones, facing cutbacks in services and possible closure.

Hospice is a proven Medicare cost saver. In 2007, an independent, Robert Wood Johnson Foundation-funded study by Duke University found that hospice reduced Medicare costs by $2,300 per patient, saving more than $2 billion per year.

Hospice is also considered to be the model of high-quality care at the end of life. Research from NHPCO shows that 98 percent of families served by hospice are willing to recommend its care and services to others.

For more information about NHPCO’s efforts to protect hospice funding, please visit NHPCO’s Advocacy Web page at: nhpco.org/advocacy.

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Contact:Angie Truesdale

Ph: 703-647-5163

atruesdale@nhpco.org

Jon Radulovic

Ph: 703-837-3139

jradulovic@nhpco.org

For more information visit, http://www.nhpco.org

Comments from Provider Needed to Protect Rates!

To: NHPCO Membership
From: NHPCO Regulatory Team
Re: June 16, 2009

The rates for hospice will be cut by 3.2% in October, and an additional 1% the following year unless CMS halts its plans to phase out the Budget Neutrality Adjustment Factor (BNAF) in the hospice wage index. Have you done everything you can to tell CMS to eliminate this rate reduction? Did you know that CMS has received NO comments from providers so far on this proposed rule? Regulators could take this lack of response from the hospice community as an indication that rate cuts will not present any problems for providers.

Act now…. Time is short...Comments are due next Monday, June 22...Tell your story about how the rate cut is affecting you and your hospice program. Here’s how...

How You Can Help
Key Issue and Talking Points: FY2010 Proposed Hospice Wage Index
Sample Letter

How You Can Help

Review the talking points below and submit your comments on the proposed rule to CMS. When preparing comments, please refer to file code CMS-1420-P. Comments must be received no later than 5:00 pm on Monday, June 22, 2009.


Electronic Comments:
The fastest and easiest way to submit comments would be electronically; visit http://www.regulations.gov/fdmspublic/component/main?main=SubmitComment&o=0900006480968c04 and follow the instructions to comment. Make sure you reference the document number: CMS-1420-P.


Written Comments:
You may mail written comments to the following address ONLY. Please allow sufficient time to ensure that mailed comments are received before the close of the comment period.

Centers for Medicare & Medicaid Services
Department of Health and Human Services
Attention: CMS–1420–P
P.O. Box 8012
Baltimore, MD 21244–8012

Express Mail:
You may send written comments (one original and two copies) to the following address ONLY.

Centers for Medicare & Medicaid Services
Department of Health and Human Services
Attention: CMS–1420–P
Mail Stop C4–26–05
7500 Security Boulevard
Baltimore, MD 21244–1850

Key Issue and Talking Points

Issue: FY2010 Proposed Hospice Wage Index

CMS proposes to continue its phase-out of the BNAF over the next two years, with a 75% reduction in FY 2010 and a complete phase-out in FY 2011.

Member Talking Points:

1. A 75% reduction in the BNAF is equal to a rate reduction of 3.2 % in FY2010, beginning October 1, 2009, and an additional one percent reduction in FY 2011, ultimately resulting in a rate reduction of approximately 4.2% for most hospices.
   Describe any direct impact the proposed rate cut will have on:
   - Patient and family services, such as: (services cut back, services discontinued, etc.)
   - Reductions in service area;
   - Employee layoffs;
   - Higher case loads;
   - Any other negative impact on program services because of the reimbursement cuts.
   
2. In a time of economic uncertainty and loss, with escalating costs (gas prices are on the rise again), a rate cut is exactly the wrong action for CMS to take.
   
3. CMS ought to encourage more patients and families to elect hospice care so that they will receive the care they need and deserve, and save the Medicare system money.

NHPCO will submit comprehensive comments but that is not enough. It is imperative that Regulators hear from members of the hospice community. It is especially important that you explain the impact these rate cuts will have on staffing and patient services.Thank you for your ongoing efforts to protect hospice!

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Note: NHPCO Regulatory Team issued a comprehensive Alert and Call to Action on June 9 that goes into more detail and looks at some of the broader issues. That alert is available on the NHPCO Web site.

For more information visit, http://www.nhpco.org